Transcript Med-HF - e
Med-HF: Algorithm to App Sheri L. Koshman BScPharm, PharmD, ACPR Assistant Professor of Medicine University of Alberta sheri.koshman@ualberta Disclosure • No conflicts of interest to disclose Outline Algorithm App Heart Failure: Burden of Illness • Over 80,000 individuals live with heart failure (HF) in Alberta • HF is typically progressive, characterized by frequently hospitalization, and a large burden on healthcare resources • Medical management, the mainstay of treatment, is complex and requires frequent dosing adjustment and monitoring • Most of these complex patients are managed in the community. • Tools are needed to support front line clinicians to help improve patient outcomes Heart Failure: Clinical Practice Tools Heart Failure: Clinical Practice Tools • End users: – Capital Health Chronic disease management HF working group (2007) – Alberta Cardiac Access Collaborative HF clinics (2009) – HF clinic nurses – Pharmacists – Alberta Health Services: Strategic Clinical Network; Heart Failure Working Group (2011) • Structured implementation into family practices Oak Bay Medical Centre, Calgary The Associate Clinic, Pincher Creek Feedback from front-line clinicians…… Great tool, but……. It’s not handy I don’t know where to start Too complicated Overwhelming After someone walked me through it, I found it easy to use There has to be a better way…… • How could we increase ease of use? • How could we increase accessibility to the end user efficiently? At the bedside? In the office? • How do we make the tools interactive? Let’s develop an App! How do we develop an App? How do we develop an App? • Strategy #1: Find someone who knows how to make an App – Canadian Cardiovascular Society (CCS) • Strategy #2: Add App development onto an existing project – Alberta Health Services: Strategic Clinical Network, Heart Failure Working Group – Partner with CCS to nationally disseminate How do we develop an App? • First steps: – Meeting with IT department (October 2011) • Understand the need and scope of the project • Determine which platform(s) to ensue • Determine project timelines Surprise! We’ve never done this before. Don’t worry…..Our programmer will go to App school. Lost in translation Algorithms App IT Clinicians Clinicians IT Working toward a common goal • 4 algorithms – Refine one at a time • All same format, increase efficiency with progression • Standardize format for App – Breakdown each section • Used Powerpoint slides to communicate vision of screens Working toward a common goal • Screen mock-ups – Used to visualize and finalize format – Multiple iterations before programming • Review and revision without downloading • Allowed for multiple reviewers: – Pharmacists – Nurses – Physicians • Project management • Establish steps • Adhere to deadlines Working toward a common goal • Programming – Xcode: storyboards – Beta-testing: • Pharmacists – Tech savvy – Student • Heart failure nurse • Physicians – Cardiology resident – Family physician – Internists • • • • • Lessons learned: Very important step Composition of beta-testers important Format matters Esthetics matter Transitions matter Graphic design was a game changer…. Administrative Processes • The players: University of Alberta (UA) and Alberta Health Services (AHS) – AHS / UA Legal – AHS Health Technology and Innovation / TEC Edmonton – AHS / UA administrative administration – Canadian Cardiovascular Society collaboration • Copyright / intellectual property rights • Disclaimer • Liability/insurance Administrative Processes • University of Alberta and AHS: The UA already registered a copyright for the algorithm content (paper version) AHS signed a royalty-free license from UA for the algorithms AHS registered a joint copyright for the mobile App We have an App…how do we get the word out? • Promotion key strategies: Launch date October 26, 2012: corresponded with the Canadian Cardiovascular Congress meeting. Internal communications (i.e. AHS Insite, Medical Affairs print/online mediums, UA) External organizations (i.e. CCS, Alberta Medical Association, Alberta Pharmacist Association) Calgary, South, Central Zone Twitter accounts News release and scheduled media interviews Feature story for AHS / UA external website Friends, family, strangers In the news…. Where are we now? • Launch on iTunes October 26, 2012 (1 year after starting) • Downloaded in 65 countries – 3174 new downloads – 12,767 user sessions – 630 active users – 44 sec - median length of session – 68% females – Highest users: 25-35, 36-54 years Where are we now? • Lots of good feedback • Lots of requests for other platforms – HTML5 program complete and awaiting server space and beta-testing • Lots of internal requests for other Apps The dream team…. Algorithm App Clinicians IT Project Management Graphic design Legal/Admin How to find us • We’re free! Download us on iTunes • https://itunes.apple.com/ca/app/medhf/id559909558?mt=8 or search Med-HF People Involved Dr. Justin Ezekowitz (Cardiologist, UA) Dr. Sheri Koshman (Pharmacist, UA) [email protected] Gerry Ison (Senior Manager-PCSD Team, AHS) Umar Sheikh (IT Analyst-PCSD Team, AHS) Taryn Heck Anne-Marie Sande Ernest Law Dr. Mike Hannen Dr. Scott Forsythe Dr. Raj Padwal Dr. Narmin Kassan Mona Dhanda (Business Analyst-PCSD Team, AHS) Telus Health Chris Carvalho (Telus Health), Vivian Woo (AHS) Monica Saromo (Robots & Pencils)